Language, Ideology and the Construction of Illness in Selected Medical Reports from Nigerian Hospitals: A Critical Discourse Analysis

Medical reports are foundational instruments of institutional healthcare communication that do more than record clinical observations; they actively construct illness, constitute patient identities, and enact professional authority through language. This paper analyses how post-diagnostic medical reports from Nigerian public hospitals discursively construct illness, patients, and biomedical ideology. Thirty reports were purposively sampled from three tertiary health institutions in Nigeria covering internal medicine, obstetrics and gynaecology, and general surgery. Data analysis follows Norman Fairclough's three-dimensional Critical Discourse Analysis model, supplemented by Michel Foucault's theory of discourse, knowledge, and power. The analysis identifies five thematic dimensions: the discursive construction of illness through diagnostic labelling, severity framing, and prognostic language; the construction of patient identity through agentive suppression and diagnostic substitution; the enactment of medical authority through modal constructions and certainty markers; the naturalisation of biomedical ideology; and the deployment of nominalisation, passive voice, jargon, presupposition, and euphemism as core linguistic strategies. Findings demonstrate that clinical language in Nigerian medical reports systematically marginalises patient subjectivity, naturalises institutional power, and suppresses the structural determinants of ill health. The study extends Nigerian medical discourse scholarship into written clinical documentation and has practical implications for medical education, clinical communication policy, and patient rights advocacy.